To summarize the first aid and nursing experience of a patient with enterobacter aerogenes infection complicated by septic shock after oral floor cancer surgery. The patient was admitted to the Department of Oral and Maxillofacial Surgery at the Second Affiliated Hospital of Zhejiang University School of Medicine in August 2023. This patient who developed enterobacter aerogenes infection complicated by septic shock after surgery for oral floor cancer was treated with a comprehensive approach. In response to the patient's rapid onset, rapid progression of the condition, and critical situation, the following key points of nursing care were formulated and implemented: this included the rapid identification of septic shock, precise execution of emergency interventions; effectiveion of airway management, active prevention of airway obstruction; implement refined nursing care, awareness of leukocyte crisis, preventing secondary infection; establishing blood alert mechanism, implementing monitoring and protection management; implementing phased progressive nutritional support, improveing the nutritional status of patients. After 21 days of intensive treatment and nursing care, the patient made a full recovery and was discharged. A 6-month follow-up revealed that the patient remained in stable condition with no recurrence.

Objective:To evaluate the effect of value orientation brief therapy(VBT)combined with selective serotonin reuptake inhibitors(SSRIs)on clinical symptoms,rumination,decision-making ability,and cognitive func-tion in patients with mild to moderate depression.Methods:Eighty patients meeting the DSM-5 diagnostic criteria for mild to moderate depression were randomly assigned to either a medication(SSRIs)group(36 completed)or a VBT combined group(38 completed)for a 6-week intervention.Baseline and post-intervention assessments includ-ed the Hamilton Depression Scale(HAMD),Hamilton Anxious Scale(HAMA),Ruminative Response Scale-Chi-nese Version(RRS-CV),Iowa Gambling Test(IGT),number of eye fixation(NEF),responsive search score(RSS)in exploratory eye trajectory movement were used to evaluate patients'anxiety and depression symptoms,ru-minative thinking,decision-making function,and cognitive function.Results:The VBT combined group showed sig-nificantly better therapeutic effects than the medication group(P＜0.05).Compared to baseline and the medication group,the VBT combined group had significantly lower post-intervention scores in HAMD,HAMA,symptom rumi-nation,introspective reflection,compulsive meditation,and RRS-CV total scores after intervention(Ps＜0.05),and significantly higher scores in IGT net profit scores,NEF,and RSS scores(Ps＜0.05).Compared with the medica-tion group,the VBT combined group demonstrated a greater reduction in HAMD,HAMA,symptom rumination,in-trospective reflection,compulsive meditation,and RRS-CV total scores before and after intervention(Ps＜0.05),and a larger increase in IGT net profit scores,NEF,and RSS scores(Ps＜0.05).Conclusion:VBT combined with SSRIs effectively improves the symptoms of depression,anxiety,decision-making ability,rumination thinking,and cognitive function in patients with mild to moderate depression.

Objective:To evaluate the effect of value orientation brief therapy(VBT)combined with selective serotonin reuptake inhibitors(SSRIs)on clinical symptoms,rumination,decision-making ability,and cognitive func-tion in patients with mild to moderate depression.Methods:Eighty patients meeting the DSM-5 diagnostic criteria for mild to moderate depression were randomly assigned to either a medication(SSRIs)group(36 completed)or a VBT combined group(38 completed)for a 6-week intervention.Baseline and post-intervention assessments includ-ed the Hamilton Depression Scale(HAMD),Hamilton Anxious Scale(HAMA),Ruminative Response Scale-Chi-nese Version(RRS-CV),Iowa Gambling Test(IGT),number of eye fixation(NEF),responsive search score(RSS)in exploratory eye trajectory movement were used to evaluate patients'anxiety and depression symptoms,ru-minative thinking,decision-making function,and cognitive function.Results:The VBT combined group showed sig-nificantly better therapeutic effects than the medication group(P＜0.05).Compared to baseline and the medication group,the VBT combined group had significantly lower post-intervention scores in HAMD,HAMA,symptom rumi-nation,introspective reflection,compulsive meditation,and RRS-CV total scores after intervention(Ps＜0.05),and significantly higher scores in IGT net profit scores,NEF,and RSS scores(Ps＜0.05).Compared with the medica-tion group,the VBT combined group demonstrated a greater reduction in HAMD,HAMA,symptom rumination,in-trospective reflection,compulsive meditation,and RRS-CV total scores before and after intervention(Ps＜0.05),and a larger increase in IGT net profit scores,NEF,and RSS scores(Ps＜0.05).Conclusion:VBT combined with SSRIs effectively improves the symptoms of depression,anxiety,decision-making ability,rumination thinking,and cognitive function in patients with mild to moderate depression.

To summarize the first aid and nursing experience of a patient with enterobacter aerogenes infection complicated by septic shock after oral floor cancer surgery. The patient was admitted to the Department of Oral and Maxillofacial Surgery at the Second Affiliated Hospital of Zhejiang University School of Medicine in August 2023. This patient who developed enterobacter aerogenes infection complicated by septic shock after surgery for oral floor cancer was treated with a comprehensive approach. In response to the patient's rapid onset, rapid progression of the condition, and critical situation, the following key points of nursing care were formulated and implemented: this included the rapid identification of septic shock, precise execution of emergency interventions; effectiveion of airway management, active prevention of airway obstruction; implement refined nursing care, awareness of leukocyte crisis, preventing secondary infection; establishing blood alert mechanism, implementing monitoring and protection management; implementing phased progressive nutritional support, improveing the nutritional status of patients. After 21 days of intensive treatment and nursing care, the patient made a full recovery and was discharged. A 6-month follow-up revealed that the patient remained in stable condition with no recurrence.

Objective:To explore the difference of inflammatory factor imbalance between adolescent and adult patients with depression.Methods:A total of 30 adolescent and 30 adult patients with depression, and 30 adolescent and 30 adult healthy controls were included from January 2022 to August 2023. Interleukin-6 (IL-6), interleukin-17 (IL-17), transforming growth factor-beta1(TGF-β1), interleukin-10(IL-10) and Maresin-1(MaR1) level were detected by enzyme-linked immunosorbent assay. 24-item Hamilton depression scale (HAMD-24) was used to assess the severity of depression in all depressed patients. SPSS 26.0 statistical software was used for t-test, covariance analysis, Spearman analysis and multivariate binary logistic regression, and the predictive value of selected inflammatory factors in depression was evaluated by receiver operating characteristic(ROC) curve. Results:(1)In adolescent group, the levels of IL-6 ((64.000±38.632) pg/mL), IL-17((239.132±49.757) pg/mL), and TGF-β1((737.267±328.447)pg/mL) in patients with depression were higher than those in control group((32.396±16.330)pg/mL, (214.954±42.326)pg/mL, (454.542±297.194)pg/mL, all P<0.05), while the level of MaR1((21 381.301±3 946.011)pg/mL) was significantly lower than that in control group((30 130.138±10 278.999)pg/mL)( P<0.001). The level of IL-17 was positively correlated with the total score of HAMD-24 ( r=0.429) and the course of disease ( r=0.571), the level of IL-10 was negatively correlated with body weight factor score ( r=-0.384), and the levels of TGF-β1 was negatively correlated with anxiety/somatization factor score ( r=-0.449)(all P<0.05) in adolescent patients with depression.MaR1( B=0.000 1, OR=0.999 8, AUC=0.794, P<0.05) was an independent risk factor for adolescents depression.(2)In adult depression group, the levels of IL-6, IL-17, IL-10, TGF-β1 and MaR1 were higher than those in adult control group(all P<0.05). The level of TGF-β1 in adult depression group was negatively correlated with the total score of HAMD-24 ( r=-0.427), the score of anxiety/somatization factor ( r=-0.368), the score of blocking factor ( r=-0.405), and the score of hopelessness factor ( r=-0.398).The level of MaR1 was positively correlated with the age of onset of disease ( r=0.425)(all P<0.05) in adult patients with depression.MaR1( B=0.000 4, OR=1.000 3, AUC=0.874, P<0.001) and IL-6( B=0.040, OR=1.040 7, AUC=0.779, P<0.05) were independent risk factors for adult depression.The AUC of IL-6 combined with MaR1 was 0.938. Conclusion:There are differences in the underlying mechanism of immune imbalance between adolescent and adult patients with depression.MaR1 may be a diagnostic biomarker for depression in adolescents and adults.

Brain edema could be secondary to cerebral lesion caused by a variety of reasons, severe cases may result in brain herniation or even death. Accurate real-time monitoring of cerebral edema, rational application of dehydrating drugs, and timely treatment of cerebral edema were very important for patients. However, there were defects in the monitoring methods commonly used in clinical practice. Noninvasive brain-edema monitoring was a new method, which can quantify the degree of brain edema by electromagnetic disturbance and directly reflect the state of brain edema. This article reviews the application of noninvasive brain-edema monitoring in the treatment of in critically ill patients with traumatic brain injury.

Objective:To explore the implementation path of scientific and technological achievement empowerment for researchers in public hospitals.Methods:Through literature research, theoretical research, policy research, etc, current situation and progress of the ownership management reform of scientific and technological achievements at home and abroad were sorted out, and the difficult problems in the empowerment of scientific and technological achievements were summarized in combination with its practice in domestic public hospitals.Results:The following problems existed in the empowerment of scientific and technological achievements in public hospitals: weak awareness of medical staff′s ownership protection imperfect empowerment system, lagging construction of management personnel, and constraints of state-owned assets management.Conclusions:It is suggested to improve the coordination mechanism of government departments, optimize related policy and law environment and innovation atmosphere, implement a categorized and tiered empowerment strategy for job scientific and technological achievements, set up a management platform of medical scientific and technological achievements, build a complete support service system, establish a mechanism for cultivating and producing high-value achievements, and strengthen the construction of achievement management personnel.

ObjectiveTo analyze the community structure and dynamics of parasitic fleas on the body surface of host animals and nested fleas in different seasons in the natural foci of wild rat plague in Yulong County，Yunnan Province， to explore the relationship between seasonal fluctuation of fleas and the prevalence of plague among animals， so as to provide evidence for plague prevention and control in the natural foci. MethodsNanxi Village， Huangshan Town， the core area of plague epidemic in Yulong County， was selected as the monitoring sample area in December 2019 （winter）， August 2020（summer）， October 2020（autumn） and March 2021（spring）. Host animals were captured by rattrap at night and rat nests were excavated for collecting parasitic fleas on host animals and rat nest fleas in different seasons. Excel 2010 and SPSS 26.0 software were used to analyze the data， and Chi square test was used to compare the rate. Community ecological indicators were used to analyze the community structure and species diversity of the host animals and their parasitic fleas. ResultsA total of 355 vector fleas were captured， belonging to 7 species of 5 genera in 2 families. 441 small animals were captured and 138 rat body fleas were detected with the flea infection rate of 14.51% and the flea index 0.31. 96 effective rat holes were excavated and 217 fleas were detected with the flea infection rate of 35.42% and the flea index 2.26. Among the four seasons， the flea infection rates of rat body and rat nests were higher in summer and winter， showing a significant difference in general （χ²=15.851， P<0.01； χ²=16.398， P<0.01）. The dominant species of flea community were Ctenophthalmus quadratus， Stenischia humilis， Neopsylla specialis and Frontopsylla spadix， with a dominance index of 0.434， 0.254， 0.180 and 0.110， respectively. The diversity and evenness of rat body fleas showed a distribution characteristic of decreasing， increasing and then decreasing again with season changes， and both were the highest in spring， while the ecological dominance showed an opposite trend. The diversity and evenness of rat nest fleas showed a distribution characteristic of increasing first and then decreasing in summer， autumn and winter， with the highest in autumn， while the ecological dominance was diametrically opposite. ConclusionThe fleas community structure is relatively stable in Yulong County， but the number of species in the community is unevenly distributed by seasons， and the status of dominant species is prominent. Local authorities should carry out timely preventive deratization and depulization measures according to the results of daily monitoring， so as to effectively avoid the prevalence and spread of plague among animals in plague foci.

Objective: This study aimed to evaluate the consistency or stability of mental disorders diagnosed in the psychiatry ward setting, investigate factors associated with consistency, and observe the disease distribution over the decade. Methods: A total of 20,359 psychiatric inpatients were included in this retrospective study from June 2011 to December 2020. Diagnoses from the first admission to discharge were evaluated to determine the diagnostic consistency during hospitalization. Readmissions were selected as the subgroup, whose first and last discharge diagnoses were compared to analyze the relatively long-term diagnostic stability. Demographic and clinical characteristics were collected to identify predictors of diagnostic discrepancy. Results: From 2011–2020, the hospitalization rate decreased from 42.7% to 20.7% for schizophrenia and grew from 13.3% to 23.8% for depression. Diagnoses were retained by 92.6% of patients at their first discharge diagnosis, ranging from 100% for disorders of psychological development to 16.3% for unspecified mental disorders. About 33.9% of diagnostic conversions were to bipolar disorder in patients having inconsistent diagnoses. However, among rehospitalizations, the diagnostic stability notably dropped to 71.3%. For rehospitalizations, mood disorders and schizophrenia spectrum disorders were relatively stable diagnoses categories, with 72.6% to 76.7% of patients receiving the same diagnosis, although results of specified diagnoses within these categories ranged from 5.9% to 91.0%. Except for mood disorders and schizophrenia spectrum disorders, the diagnoses of all other categories were below 70%. Long lengths of hospitalization and old age were associated with short-term diagnosis alterations. Conclusion Longitudinal follow-up and integration of multiple aspects of information are essential for accurate diagnosis.